Diagnosing The Impact On Patients When Trusted Doctors Sell A Practice

A blizzard was coming and the doctor knew that meant bad news for his patients with upcoming appointments.

They might become snowed in and not be able to get out of their homes. In the past, the doctor handled such situations by contacting the patients and offering to let them come in ahead of the storm.

But the doctor had recently been forced to sell his practice to a hospital and the hospital now called the shots.

“The hospital said they were not going to do what he had always done,” says Dennis Hursh, an attorney who has provided legal services to physicians for more than three decades and is the author of “The Final Hurdle: A Physician’s Guide to Negotiating a Fair Employment Agreement.” (www.TheFinalHurdle.com)

“Essentially, the hospital took the view that if the patients were trapped by the blizzard and couldn’t make it to their appointments, that was just too bad.”

The blizzard scenario is one of the more extreme examples of the types of situations patients face when a long-trusted doctor sells a private practice and becomes part of a hospital.

“I’ve represented many physicians who sell their practices to hospitals,” Hursh says. “Some of these physicians were forced to sell because the costs of running their practices were increasing, while reimbursement from health insurance companies remained constant or fell.”

Unless the doctor is careful with contract negotiations, though, he or she may not always be happy with the way things work out.

And the doctor’s patients could be even less happy.

“These things do affect the patients,” Hursh says. “They may have counted on that doctor for years, or even decades. And suddenly, everything changes.”

For the patients, that could mean:

• A rushed visit. Doctors who own their own practices tend to take time with their patients. A relationship develops, Hursh says. “A hospital might want the doctor to see eight patients an hour,” he says. “Doctors by necessity can become more abrupt in their dealings with the patients when they work for a hospital. It becomes more focused on money making than on patient care.”

 A switch in doctors. Patients may not always see their trusted physician when they schedule a visit. They have gone from being treated by a single doctor to being treated by a multi-doctor practice. On any given visit, they potentially could end up seeing one of the other doctors. “You lose the one on one,” Hursh says. “You feel every time you go in you are seeing a stranger.”

 Adjustment difficulties. Patients who are senior citizens often have even more trouble than others adjusting to the change. “A lot of senior citizens won’t go in because they won’t get to see their doctor,” Hursh says. “So they just stop going to the doctor, which isn’t in their best interests.”

Hursh says that, in reality, some physicians who go in with a hospital probably never should have sold their practices to begin with – at least not under the conditions that were agreed upon.

Often, doctors believe their compensation will increase if they become employed by the hospital, but that’s not necessarily so, he says.

“Selling a medical practice can be a frustrating experience,” Hursh says. “Getting the best deal can be complicated. It’s clearly in the best interests of the doctor to get a good deal, but ultimately it’s also important for the patients. I want my doctor to be focused on me and my health needs, not stewing over a contract that leaves them short-changed.

About Dennis Hursh

Dennis Hursh, author of “The Final Hurdle: A Physician’s Guide to Negotiating a Fair Employment Agreement,” has been providing health-care legal services for more than three decades. Since 1992, he has been managing partner of Hursh & Hursh, P.C., www.PaHealthLaw.com, a Pennsylvania law firm that serves the needs of physicians and medical practices. He is a member of the American Health Lawyers Association, where he is involved in the Physician Organizations Practice Group.

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